Incidence and predictive factors of non adherence to therapy in young adults attending a psycho social center in Milan: a retrospective observational “Real world” study

INTRODUCTION: Non adherence to psychotropic drugs is associated with negative outcomes, including hospitalizations, aggressive behaviors, suicide attempts and increased premature mortality. It represents a psychiatric challenge, especially in young adults who show higher risk of non-adherence to treatment OBJECTIVES: Firstly this study evaluates the incidence of non-adherence to therapy in 18-24 years patients from a Psycho-Social Center in Milan; and then to analyze the predictive factors of non-adherence. METHODS: In this retrospective “Real Life” observational study, 120 outpatients aged 18 to 24 years, from Psycho-social Center of L. Sacco University Hospital in Milan, were recruited in 2019. Non-adherence to treatment, according to the World Health Organization, was considered “a modality of assuming medications that does not correspond to healthcare professionals’ recommendations”. Statistical analysis were performed with chi-square, ANOVA and linear regression tests, setting significance to p<0.05. RESULTS: 88 of 120 outpatients (73.3%) received an indication to psychopharmacological treatment. Of these, 23 (26.1%) did not show adherence to therapy. Results showed a positive association between non-adherence and increased hospitalizations (p <.01), oral antipsychotics (p<.05) and drop-out rates (p<.001). A significant correlation was also observed between non-adherence and Intellectual Disability (p<.05), Bipolar Disorder (p<.05), psychotic symptoms (p<.05), alterations in affectivity and mood (p<.005), alterations in sleep pattern (p<.05), school dropout (p<.05) and poor family support (p<.01). CONCLUSIONS: This study confirms that non-adherence has a relevant incidence in young-adults psychiatric population, highlighting the importance of effective and structured assessment in clinical practice to identify predictive factors and risk profiles associated with this phenomenon. DISCLOSURE: No significant relationships.